A report by the Centers for Disease Control and Prevention said the continued reporting of new cases indicates there is an ongoing risk for transmission to humans in the Arabian Peninsula area.
All reported cases of Middle East Respiratory Syndrome Coronavirus were directly or indirectly linked to one of four countries: Saudi Arabia, Qatar, Jordan and the United Arab Emirates. Forty cases were reported by Saudi Arabia. The United Kingdom, Italy, France and Tunisia reported cases involving travelers to the Arabian Peninsula and close contacts.
The original source or sources, route of transmission to humans and the mode of human-to-human transmission have not been determined, the report said.
Eight clusters involving 42 cases reported by France, Italy, Jordan, Saudi Arabia, Tunisia and the United Kingdom were among close contacts or in healthcare settings and provide clear evidence of human-to-human transmission, the report said.
Patients who develop severe acute lower respiratory illness within 14 days after traveling from the Arabian Peninsula or neighboring countries should be evaluated according to the guidelines at www.cdc.gov/coronavirus/mers/case-def.html, CDC officials said.
Those whose respiratory illness remains unexplained and who meet criteria for "patient under investigation" should be reported immediately to CDC via state and local health departments, the report said.
The report was published in the CDC's Morbidity and Mortality Weekly Report.